NR 304 EXAM 2 STUDY GUIDE
Chapters 5, 22, & 23
1. Cranial nerves
a. 1: Olfactory nerve
i. With closed eye, occlude one naris at a time and ask client to
identify odor
b. 2: Optic nerve
i. Test near and distant vision
c. 3,4,6: Oculomotor, trochlear, and abduens, always go together:
i. Test direct and consensual pupillary reaction to light
ii. Test 6 cardinal points of gaze
d. 5: Trigeminal nerve
i. With eyes closed touch the face with a cotton ball
e. 7: Facial nerve
i. look for symmetry and test for motor-activity of the nerve by
asking patient to smile, raise eyebrows
f. 8: Vestibulococholear nerve
i. Rinne and Weber test AC > BC
ii. Romberg test: balance
g. 9, 10: glossopharyngeal and vagus nerve
i. Test motor activity (open and close mouth)
ii. Depress tongue, make them say “ah”
iii. Test gag reflex
h. 11: Accessory nerve
i. Test the trapezius muscle, shrug shoulders, test strength
i. 12: Hypoglossal nerve
i. Test movement and strength of the tongue
, j.
2. Nervous system:
a. Central nervous system
i. Brain
1. Covered and protected by meninges, cerebro spinal
fluid and skull
2. Parts of the brain:
a. Cerebrum
b. Diencephalon
c. Cerebellum
d. Brain stem
ii. Spinal cord
b. Peripheral Nervous system
i. Cranial nerves
ii. Spinal nerves
c. Infants and children
i. Fetal period: very rapid nervous system growth
ii. Neonate: primitive reflex at birth (sucking, stepping, startle
and Babinski. The Babinski reflex and the tonic neck reflex are
normal until around 2 years of age)
iii. Infancy: neurons mature, cerebral cortex thickens, brain size
increases and myelinization occurs
d. Pregnant
i. Neurological changes in the legs due to pressure placed on
nerves in the pelvis
e. Older adult
i. Coordination and movement may be slower and affect ADL and
self-care
ii. Diminishes acuity on hearing, vision, smell, taste, and touch
iii. Gait: short, shuffling, uncertain, and unsteady steps
3. Motor function
Chapters 5, 22, & 23
1. Cranial nerves
a. 1: Olfactory nerve
i. With closed eye, occlude one naris at a time and ask client to
identify odor
b. 2: Optic nerve
i. Test near and distant vision
c. 3,4,6: Oculomotor, trochlear, and abduens, always go together:
i. Test direct and consensual pupillary reaction to light
ii. Test 6 cardinal points of gaze
d. 5: Trigeminal nerve
i. With eyes closed touch the face with a cotton ball
e. 7: Facial nerve
i. look for symmetry and test for motor-activity of the nerve by
asking patient to smile, raise eyebrows
f. 8: Vestibulococholear nerve
i. Rinne and Weber test AC > BC
ii. Romberg test: balance
g. 9, 10: glossopharyngeal and vagus nerve
i. Test motor activity (open and close mouth)
ii. Depress tongue, make them say “ah”
iii. Test gag reflex
h. 11: Accessory nerve
i. Test the trapezius muscle, shrug shoulders, test strength
i. 12: Hypoglossal nerve
i. Test movement and strength of the tongue
, j.
2. Nervous system:
a. Central nervous system
i. Brain
1. Covered and protected by meninges, cerebro spinal
fluid and skull
2. Parts of the brain:
a. Cerebrum
b. Diencephalon
c. Cerebellum
d. Brain stem
ii. Spinal cord
b. Peripheral Nervous system
i. Cranial nerves
ii. Spinal nerves
c. Infants and children
i. Fetal period: very rapid nervous system growth
ii. Neonate: primitive reflex at birth (sucking, stepping, startle
and Babinski. The Babinski reflex and the tonic neck reflex are
normal until around 2 years of age)
iii. Infancy: neurons mature, cerebral cortex thickens, brain size
increases and myelinization occurs
d. Pregnant
i. Neurological changes in the legs due to pressure placed on
nerves in the pelvis
e. Older adult
i. Coordination and movement may be slower and affect ADL and
self-care
ii. Diminishes acuity on hearing, vision, smell, taste, and touch
iii. Gait: short, shuffling, uncertain, and unsteady steps
3. Motor function
